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Plan Documents
https://www.caresource.com/plans/marketplace/plan-documents/...Benefits-At-A-Glance CareSource insurance plans for individuals and families provide comprehensive benefits including preventive care. Prior authorization is required for certain services. Benefits at a Glance Use this guide to see...
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Member Rights & Responsibilities
https://www.caresource.com/plans/marketplace/plan-documents/rights-responsibilities/...your premium. Comply with all provisions of the policy that are outlined in the Certificate of Coverage. This includes Prior Authorization Know and confirm your benefits before receiving treatment. Show...
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Additional Services
https://www.caresource.com/plans/medicaid/benefits-services/additional-services/...dentist and/or prior authorization from CareSource. Your dentist will make the request on your behalf. Depending on your plan, you may have more benefits. Please contact Member Services if you...
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Drug Transition Policy
https://www.caresource.com/benefits-services__trashed/pharmacy/drug-transition-policy/...the new calendar year, such as prior authorization or step therapy requirements. You can get a transition refill up to 90 days after enrolling in a new plan or after...
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Medicare and Medicaid with MyCare Ohio
https://www.caresource.com/plans/mycare/benefits-services/medicare-medicaid/...(Periodontics)* Root Canals Routine Tooth Extractions Surgical Extractions* & Other Oral Surgery * Approval or prior authorization required. We cover routine eye exams and eyewear. If you are under the...
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Forms
https://www.caresource.com/arkansas/forms/Provider Attestation Form – Submit this form to attest to practice competency prior to working with CareSource. CCVS Provider Authorization and Release Form – Submit this form to authorize release...
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Medication Therapy Management
https://www.caresource.com/members/tools-resources/find-my-prescriptions/medication-therapy-management/...more. Call Member Services to ask about our list of covered medications and those that need prior authorization. Medication Therapy Management, or MTM, is a service we offer at no...
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Changes to the Drug List
https://www.caresource.com/plans/medicaid/benefits-services/pharmacy/preferred-drug-list/pdl-changes/...1, 2019 03/01/2019 Member Web Summary of Formulary Changes Effective January 1, 2019 12/01/2018 Notification Date Posted Summary of Formulary/Prior Authorization Changes Effective April 1, 2026 03/01/2026 Summary of Formulary...
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Care And Disease Management
https://www.caresource.com/providers/education/patient-care/care-management-disease-management/...increases access to necessary medications such as MAVYRET for Medicaid beneficiaries by removing the prior authorization requirements and dispensing the medication in an eight-week supply (or a 12-week supply, when...
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Fraud, Waste & Abuse
https://www.caresource.com/providers/education/fraud-waste-abuse/...verify procedures and payment mechanisms are compliant. Our proactive monitoring includes prepay review edits, prior authorization monitoring, analytic performance dashboard monitoring, and verification of services. Our reactive monitoring includes data...
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